Ludwig’s angor is a situation that can occur after dental procedures, such as a tooth extraction, for example, especially in people with weakened immune systems, being mainly caused by bacteria that can easily reach the bloodstream and increase the risk of complications, such as respiratory failure. sepsis.
Symptoms of Ludwig’s angina may appear hours after the procedure, characterized by increased saliva production, high fever, pain and difficulty opening the mouth and swallowing. It is important that the diagnosis is made as soon as the first symptoms appear, as it is then possible to start treatment immediately, which usually involves the use of antibiotics.
Signs and symptoms of Ludwig angina may appear hours after the dental procedure and may include:
Ludwig angina is more common in people with some of the risk factors, such as excessive consumption of alcoholic beverages, diabetes, kidney problems, use of immunosuppressive drugs, immunosuppressive diseases, tongue perforation, aplastic anemia or neoplasms in the oral cavity.
Diagnosis of this type of angor is very important because the disease is evolving rapidly and can be associated with several complications. Therefore, it is important that the diagnosis is made as soon as the first signs and symptoms appear, and X-ray and CT scan are usually indicated.
In addition, laboratory tests such as the blood formula, tests evaluating kidney function and a microbial culture followed by an antibiotic may also be recommended to identify the infectious agent and the best antibiotic to combat it.
Most cases of Ludwig angina are related to a bacterial infection after tooth extraction, especially in people with weakened immune systems, and bacteria are most commonly associated with Streptococcus viridans, Staphylococcus aureus and Prevotella melaninogenica. These bacteria can proliferate at the site and spread rapidly into the bloodstream, increasing the risk of complications.
However, in addition to infection, Ludwig’s angina can occur due to jaw fractures, an abscess in the amygdala, cuts in the oral mucosa, the presence of foreign bodies in the mouth, cysts or tumors at the site, or a sialolitase, in which small stones form. resulting in pain, swelling and difficulty swallowing, for example. See what sialolithiasis is and how to identify it.
Complications of Ludwig angina are related to the bacteria’s ability to proliferate and spread rapidly into the bloodstream, reaching other organs. Thus, it can reach the mediatin, which is one of the chest cavities, favoring the compression of the heart and reaching the lungs, which can lead to severe respiratory failure.
In addition, due to the spread of the microorganism in the bloodstream, there may also be sepsis, which is a serious situation and can also lead to death, as it promotes changes in organ function. Learn how to identify sepsis.
Treatment of Ludwig angina should be initiated immediately after diagnosis to reduce the risk of complications, with antibiotics generally initially indicated to control the microorganism responsible for infection, reduce its multiplication rate and relieve symptoms.
In addition, drainage and removal of the infectious outbreak is most often done to completely eliminate the bacteria involved in angina to avoid the occurrence of complications. It is also recommended to maintain the airways, which promotes the quality of life of the person. In more severe cases, a tracheostomy may be indicated.